Prevalence of diabetic retinopathy and associated risk factors in diabetic type II patients in Ajdabiya, Libya

Diabetic retinopathy (DR) is One of the most wellknown microvascular complications of diabetes mellitus (DM) and is a frequent side effect of untreated diabetes that can lead to blindness and visual impairment. This study was conducted to assess the prevalence of diabetic retinopathy and associated factors among type 2 diabetic patients. A cross sectional study was done at Ajdabiya diabetic center from November 2023 to January 2024. Subjects and Methods: 52 patients (104 eyes) with T2DM were included in this study, their fasting blood sugar and glycosylated hemoglobin level, lipid profile measured.in addition to fundus examination (done by noncontact +90-diopter lens), fundus photographs taken by Non-Mydriatic Fundus Camera TFC-1000. Around 61 eyes (58.7%) had diabetic retinopathy, 27 eyes (26%) had back ground DR, 6 eyes (5.8 %) had pre-proliferative DR, 4 eyes (3.8%) had proliferative DR, 2 eyes (1.9%) had advanced diabetic eye disease, 22 eyes (21.2%) had CSME. Their ages ranges between 36­74 years with mean (58.90) years, (26.9%) were males, (73.1%) were females. There was a significant association between the development of DR and duration of DM (p=0.003), The FBS levels were also determined to be a significant risk factor for DR (p = 0.031), also LDL with (p=0.039). No other factors were found to have a significant association with DR. In this study more than half of diabetic patients had diabetic retinopathy. There was a significant association between the development of DR and duration of DM, FBS, LDL levels, there was no significant relation between diabetic retinopathy and hypertension, HgA1c Serum cholesterol or triglyceride levels or previous cataract surgery.

Quantitative estimation of Carthamin and Carthamidin from the Florets C. tinctorius L., (Safflower Florets)

Natural colorants derived fom plant materials have gained increasing popularity due to their non toxic nature. pigment extraction from the florets is normally done by Soxhlet extraction, maceration, and hydro distillation are conventional methods that have been widely used in industry and laboratory .phytochemical analysis of safflower florets revealed the plant presence of high amount of Carthamin and carthamidin.

Anosmia in COVID-19 Patients: Can We Predict the Severity of Chest Manifestations?

Abstract Introduction Anosmia is one of the common symptoms of COVID-19, the link between severity of chest infection and anosmia was investigated by few studies. Objectives To find an association between anosmia and severity of chest infection. Methods An analysis of patients admitted to isolation hospital of our university with confirmed polymerase chain reaction positive testing for COVID-19, between March 2021 until September 2021. We called all patients who reported anosmia during their time of illness and asked them about anosmia. We examined their chest CT. A statistical analysis was done. Results A total of 140 patients completed the study; 65% were female and 56.4% had complete anosmia. Anosmia was significantly associated with loss of taste. Smell returned in 92.5% of anosmic patients. Duration of smell loss was ~ 2 weeks in 40.5%. The most common symptoms associated with anosmia were running nose, sore throat, fever, and cough. Loss of smell was significantly associated with mild chest disease. 73.4% of anosmic patients had mild chest infection, 21.5% of them had moderate infection, and 5.1% had severe chest infection. Conclusion The pattern of anosmia in COVID-19 patients has some common similarities in general; the way it starts, the associated symptoms, the time until smell returns and, the most important, the severity of chest infection. As anosmia is significantly associated with mild chest infection. the presence of anosmia could be an independent predictor of good COVID-19 outcome as reflected by a lower disease severity and less frequent ICU admissions.

Screening of lysine production by Escherichia coli and Klebsiella isolates at different carbon sources

Lysine is an essential amino acid that is not biologically manufactured in the body. Different chemical methods for lysine production are expensive and give low yields. The present study was conducted with the purpose to evaluate the biochemical production of lysine by different carbon sources using bacterial isolates. Three carbon sources namely glucose, sucrose, and fructose were used to evaluate the biochemical production of lysine by Escherichia coli and Klebsiella spp. isolates. Optimum incubation periods were between 48-96 hours. An extensive amount of lysine was produced by all of these isolates in L6 fermentation medium. Maximum lysine was produced by Klebsiella isolate K1 6.48 g/L after 96 hours of incubation by using glucose as carbon source followed by 6.0 g/L by Klebsiella isolates K3 after 72 hours of incubation when sucrose was used as a carbon source at 37 °C. Highest amount of lysine was produced at 96 hours by Klebsiella isolates in addition to E. coli. From all three carbon sources using Klebsiella isolates and E. coli, glucose showed better lysine production.

External Auditory Canal: Computed Tomography Analysis and Classification

Abstract Introduction Computed tomography (CT) details of the external auditory canal (EAC) are not fully covered in the literature, so building up base for the CT evaluation and description is important. Preoperative details of the EAC are mandatory before any approach or procedure involving the canal. Objective To determine the different dimensions, measurements, and grading of the EAC by CT scan that were not previously published. Methods The CTscans of 100 temporal bones (200 sides) were included. Axial images were acquired with multiplanar reformates to obtain delicate details in coronal and sagittal planes for all subjects. Results At the EAC entry, the mean vertical length (height) was 7.75 ± 1 mm, and its mean horizontal length (width) was 6.1 ±0.8. At the bony cartilaginous junction of the EAC, the mean vertical length was 7.88 ±1 mm, and its mean horizontal length was 6.22 ± 0.9. At the EAC isthmus, the mean vertical length was 6.8 ± 0.97 mm, and its mean horizontal length was 5.2 ± 0.76. At the medial end of the EAC, the mean vertical length was 7.1 ±0.9 mm, and its mean horizontal length was 5.4 ± 0.85. There were no reported significant differences between right and left sides in all dimensions. Males showed significantly longer vertical and horizontal dimensions of the EAC entry, vertical dimension of the isthmus, and vertical dimension of the medial end of the EAC than females. Conclusion This study improves otologists and radiologists' awareness of EAC variations in the ear field and can be of help to residents in training.

Readiness of clients in returning to face-to-face therapy in an outpatient rehabilitation clinic: a preliminary study

BACKGROUND@#The Clinic for the Therapy Services (CTS) has considered reverting to face-to-face service delivery due to the downward trend in COVID-19 cases in the Philippines. However, the clinic has yet to investigate the willingness of the clients to this mode as a basis for its effective implementation.@*OBJECTIVES@#The study described the readiness of CTS clients in returning to face-to-face therapy amidst the pandemic. It also discussed the factors affecting readiness based on a survey.@*METHODOLOGY@#Fifty-five screened survey responses on the readiness of clients in returning to face-to-face therapy were gathered from January 30 to February 28, 2021. These underwent retrospective data analysis. Eight prospective online key informant interviews were conducted for clarifications in May 2022. This study utilized a descriptive analysis of quantitative categorical variables and a thematic content analysis of qualitative data.@*RESULTS@#The majority of the respondents (35) stated readiness to attend face-to-face therapy followed by those who answered “No” (11), “Maybe” (5), and others (4). Factors that may have affected readiness included travel, characteristics of face-to-face therapy, health conditions, vaccine, and COVID-19 concerns. Frequently preferred health and safety strategies were the provision of hygiene products, disinfection, limited people inside the clinic, separate therapy areas, and ventilation.@*CONCLUSION@#Most of the respondents expressed willingness to receive face-to-face therapy in April or May of 2021. Feasibility of travel and decreased number of COVID-19 cases may have encouraged willingness to attend. Those who were hesitant reported concerns with traveling, characteristics of face-to-face therapy, health conditions, the COVID-19 situation, and the vaccine.

Cardiology residents’ attitudes towards clinical supervision: a multi-centered study / 한국의학교육

Purpose@#Residents’ gender, residency level, and hospital types might influence their attitudes towards clinical supervision (CS); however, reports of its impact on cardiology residency are nonexistent. We explore the effect of gender, residency level, and hospital location’s effect on Indonesian cardiology trainees’ attitudes towards CS. @*Methods@#A multi-centered, cross-sectional study was conducted. We invited 490 Indonesian cardiology residents in September– October 2019 to complete the Cardiology CS Scale. Residents’ attitudes, gender, university, and residency year were expressed using descriptive statistics. A Mann-Whitney test analyzed the gender and university location effect on residents’ attitudes. Training year and university’s impact were subjected to the Kruskal-Wallis test; a p-value of <0.05 reflected a significant result. @*Results@#A total of 388 residents agreed to participate (response rate=79.18%). Most of them were male (n=229 [59,02%]), attended universities in Java Island (n=262 [67,52%]), and were in their 2nd–3rd year of training (n=95 [24.48%], each). There were no significant differences in residents’ attitudes between genders (U [Nmale=229, Nfemale=159]=17,908.50, z=-0.27, p=0.78). Generally, their attitudes were significantly affected by the university (H(7)=47.38, p<0.01). However, the university location (located in Java Island or outside Java Island) does not affect residents’ attitude towards CS (U [NJava=262, Nnon-Java=126]=15,237.00, z=-1.23, p=0.22). In addition, the residents’ training year also affected the residents’ response (H(2)=14.278, p<0.01). @*Conclusion@#Cardiology residents’ attitudes towards CS are significantly influenced by training year and university but not gender or university location. The results might provide insightful information for further improvement of CS in cardiology training and guide further evaluation.

Whole genomic sequencing of Staphylococcus aureus strain RMI-014804 isolated from pulmonary patient sputum via next-generation sequencing technology

Nosocomial infections, commonly referred to as healthcare-associated infections, are illnesses that patients get while hospitalized and are typically either not yet manifest or may develop. One of the most prevalent nosocomial diseases in hospitalized patients is pneumonia, among the leading causes of mortality and morbidity. Viral, bacterial, and fungal pathogens cause pneumonia. More severe introductions commonly included Staphylococcus aureus, which is at the top of bacterial infections, per World Health Organization reports. The staphylococci, S. aureus, strain RMI-014804, mesophile, on-sporulating, and non-motile bacterium, was isolated from the sputum of a pulmonary patient in Pakistan. Many characteristics of S. aureus strain RMI-014804 have been revealed in this paper, with complete genome sequence and annotation. Our findings indicate that the genome is a single circular 2.82 Mbp long genome with 1,962 protein-coding genes, 15 rRNA, 49 tRNA, 62 pseudogenes, and a GC content of 28.76%. As a result of this genome sequencing analysis, researchers will fully understand the genetic and molecular basis of the virulence of the S. aureus bacteria, which could help prevent the spread of nosocomial infections like pneumonia. Genome analysis of this strain was necessary to identify the specific genes and molecular mechanisms that contribute to its pathogenicity, antibiotic resistance, and genetic diversity, allowing for a more in-depth investigation of its pathogenesis to develop new treatments and preventive measures against infections caused by this bacterium.

A Theory-Based, Technology-Assisted Intervention in a Hybrid Cardiac Rehabilitation Program for Patients with Coronary Heart Disease: A Feasibility Study

Purpose@#To assess the feasibility of a technology-assisted intervention in a hybrid cardiac rehabilitation program among patients with coronary heart disease. @*Methods@#This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks). @*Results@#Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were “very satisfied” (23.1%) and “satisfied” (76.9%) with the technology-assisted intervention. @*Conclusions@#The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.

Serum Procalcitonin Guide in a Case of Proteus mirabilis Prosthetic Joint Infection

@#Infection is a dreaded complication in patients who have underwent arthroplasty and often very challenging to treat. It accounts for lesser than 1% of arthroplasty cases and although low in occurrence, requires appropriate investigations and management to successfully treat the condition. This case demonstrates a case of a rare microorganism with unusual antibiotic susceptibility causing a prosthetic joint infection and the use of serum procalcitonin level as guide in management of the patient.

Recurrence of hepatitis C virus after treatment with pegylated interferon and direct acting antivirals in Punjab Pakistan / Recorrência do vírus da hepatite C após tratamento com interferon peguilado e antivirais de ação direta em Punjab, Paquistão

Although increased response rates concomitant in hepatitis C virus but relapse after treatment is threatened. Therefore, it is terrible requirement to evaluate the response of Pegylated interferon and direct acting antivirals in Punjab Pakistan. The study was conducted to find the rate of recurrence of HCV infection after treatment with Pegylated Interferon and Direct Acting Antivirals in Punjab Pakistan. This study was conducted at Department of Pathology, Nawaz Sharif Medical College Gujrat, while treatment effects monitored in different Government and Private Hospitals of Punjab, Pakistan. Total 973 patients who administered the recommended dose and divided in two groups (i) Interferon based therapy (ii) direct acting antivirals (DAAs).Other parameters like ALT and viral load studied. The rate of recurrence was higher in female infected with genotype 2b and in male with mixed genotype 3a/2b after six month of antiviral therapy. Genotype 3a showed significant response to therapy after three month. 32 among 374 (8.5%) were positive after 24 weeks of treatment with interferon, 29 (7.7%) patients have same genotype while 3 patients were re-infected with different HCV strains. With DAAs, only 27 (4.8%) patients were positive among 558 after 2 weeks and one patient re-infected with different genotype. Early and sustained virological response noted in DAAs. ALT and viral load decreased faster with DAAs that not achieved after 4 weeks with pegylated interferon. Sustained virological response appears in DAAs and recurrence rate is high in interferon therapy compared to DAAs. Therefore, reinfection has implications for correct treatment efficiency and to select strategies for retreatment cases.

Embora aumentem as taxas de resposta concomitantes no vírus da hepatite C (HCV), há risco de recidiva após o tratamento. Portanto, é um requisito terrível avaliar a resposta do interferon peguilado e antivirais de ação direta em Punjab, Paquistão. O estudo foi conduzido para encontrar a taxa de recorrência da infecção por HCV após o tratamento com interferon peguilado e antivirais de ação direta em Punjab, Paquistão. Este estudo foi conduzido no Departamento de Patologia Nawaz Sharif Medical College Gujrat, enquanto os efeitos do tratamento foram monitorados em diferentes hospitais públicos e privados de Punjab, Paquistão. Total de 973 pacientes que administraram a dose recomendada foram divididos em dois grupos: (i) Terapia baseada em interferon, (ii) antivirais de ação direta (DAAs). Outros parâmetros como ALT e carga viral foram estudados. A taxa de recorrência foi maior em mulheres infectadas com o genótipo 2b e em homens com genótipo misto 3a / 2b após seis meses de terapia antiviral. O genótipo 3a mostrou resposta significativa à terapia após três meses. 32 entre 374 (8,5%) foram positivos após 24 semanas de tratamento com interferon, 29 (7,7%) pacientes têm o mesmo genótipo, enquanto 3 pacientes foram reinfectados com diferentes cepas de HCV. Com DAAs, apenas 27 (4,8%) pacientes foram positivos entre 558 após duas semanas e um paciente reinfectado com genótipo diferente. Resposta virológica precoce e sustentada observada em DAAs. ALT e carga viral diminuíram mais rapidamente com DAAs, que não alcançou após 4 semanas com interferon peguilado. A resposta virológica sustentada aparece em DAAs, e a taxa de recorrência é alta na terapia com interferon em comparação com DAAs. Portanto, a reinfecção tem implicações para a eficiência do tratamento correto e para selecionar estratégias para casos de retratamento.

Recurrence of hepatitis C virus after treatment with pegylated interferon and direct acting antivirals in Punjab Pakistan

Abstract Although increased response rates concomitant in hepatitis C virus but relapse after treatment is threatened. Therefore, it is terrible requirement to evaluate the response of Pegylated interferon and direct acting antivirals in Punjab Pakistan. The study was conducted to find the rate of recurrence of HCV infection after treatment with Pegylated Interferon and Direct Acting Antivirals in Punjab Pakistan. This study was conducted at Department of Pathology, Nawaz Sharif Medical College Gujrat, while treatment effects monitored in different Government and Private Hospitals of Punjab, Pakistan. Total 973 patients who administered the recommended dose and divided in two groups (i) Interferon based therapy (ii) direct acting antivirals (DAAs).Other parameters like ALT and viral load studied. The rate of recurrence was higher in female infected with genotype 2b and in male with mixed genotype 3a/2b after six month of antiviral therapy. Genotype 3a showed significant response to therapy after three month. 32 among 374 (8.5%) were positive after 24 weeks of treatment with interferon, 29 (7.7%) patients have same genotype while 3 patients were re-infected with different HCV strains. With DAAs, only 27 (4.8%) patients were positive among 558 after 2 weeks and one patient re-infected with different genotype. Early and sustained virological response noted in DAAs. ALT and viral load decreased faster with DAAs that not achieved after 4 weeks with pegylated interferon. Sustained virological response appears in DAAs and recurrence rate is high in interferon therapy compared to DAAs. Therefore, reinfection has implications for correct treatment efficiency and to select strategies for retreatment cases.

RESUMO Embora aumentem as taxas de resposta concomitantes no vírus da hepatite C (HCV), há risco de recidiva após o tratamento. Portanto, é um requisito terrível avaliar a resposta do interferon peguilado e antivirais de ação direta em Punjab, Paquistão. O estudo foi conduzido para encontrar a taxa de recorrência da infecção por HCV após o tratamento com interferon peguilado e antivirais de ação direta em Punjab, Paquistão. Este estudo foi conduzido no Departamento de Patologia Nawaz Sharif Medical College Gujrat, enquanto os efeitos do tratamento foram monitorados em diferentes hospitais públicos e privados de Punjab, Paquistão. Total de 973 pacientes que administraram a dose recomendada foram divididos em dois grupos: (i) Terapia baseada em interferon, (ii) antivirais de ação direta (DAAs). Outros parâmetros como ALT e carga viral foram estudados. A taxa de recorrência foi maior em mulheres infectadas com o genótipo 2b e em homens com genótipo misto 3a / 2b após seis meses de terapia antiviral. O genótipo 3a mostrou resposta significativa à terapia após três meses. 32 entre 374 (8,5%) foram positivos após 24 semanas de tratamento com interferon, 29 (7,7%) pacientes têm o mesmo genótipo, enquanto 3 pacientes foram reinfectados com diferentes cepas de HCV. Com DAAs, apenas 27 (4,8%) pacientes foram positivos entre 558 após duas semanas e um paciente reinfectado com genótipo diferente. Resposta virológica precoce e sustentada observada em DAAs. ALT e carga viral diminuíram mais rapidamente com DAAs, que não alcançou após 4 semanas com interferon peguilado. A resposta virológica sustentada aparece em DAAs, e a taxa de recorrência é alta na terapia com interferon em comparação com DAAs. Portanto, a reinfecção tem implicações para a eficiência do tratamento correto e para selecionar estratégias para casos de retratamento.

Lesión de la mucosa intestinal asociada a cristales: serie de casos y revisión de la literatura / Intestinal mucosal lesion associated with crystals: Case series and literature review

Resumen La lesión de la mucosa asociada a cristales es un cuadro clínico importante en un subconjunto de pacientes urémicos a los que se les administran resinas de intercambio catiónico como el sulfonato de poliestireno sódico (Kayexalate) y sevelamer para el tratamiento de la hiperpotasemia y la hiperfosfatemia, respectivamente. La necrosis colónica en estos pacientes es rara, pero puede estar asociada a una lesión gastrointestinal mortal, con una tasa de mortalidad del 33%. Los secuestrantes de ácidos biliares son otro tipo de resina que teóricamente son biológicamente inertes. Se presentan dos casos de colitis asociada a cristales. El primer paciente tenía antecedentes de múltiples intervenciones quirúrgicas y patologías del tracto gastrointestinal, y estaba en manejo con colestiramina. Se realizó una sigmoidectomía en la que se encontraron varios focos de cristales. El segundo paciente tenía antecedente de enfermedad renal crónica que requirió el uso de Kayexalate y se presentó al servicio de urgencias con una hemorragia grave del tracto gastrointestinal inferior. Se realizó una colectomía parcial en la que se detectaron cambios morfológicos relacionados con el depósito de cristales. Las resinas pueden producir un amplio espectro de lesiones mortales de la mucosa, por lo que el diagnóstico precoz es fundamental para disminuir la mortalidad y mejorar el pronóstico. Sin embargo, es incierto si el consumo de colestiramina y Kayexalate, así como el depósito de sus cristales en el tracto gastrointestinal son el factor causal de la lesión de las mucosas. Por tanto, la presencia de resinas debería ayudar a establecer el diagnóstico correcto y el tratamiento médico oportuno para evitar resultados nocivos.

Abstract Crystal-associated mucosal injury is a crucial clinical picture in a subset of uremic patients who are given cation exchange resins such as sodium polystyrene sulfonate (Kayexalate) and sevelamer to treat hyperkalemia and hyperphosphatemia, respectively. Colonic necrosis in these patients is rare but may be associated with fatal gastrointestinal injury, with a mortality rate of 33%. Bile acid sequestrants are another type of resin that is theoretically biologically inert. Two cases of colitis associated with crystals are presented. The first patient had a history of multiple surgeries and pathologies of the gastrointestinal tract and was treated with cholestyramine. A sigmoidectomy was performed in which several crystal foci were found. The second patient had a history of chronic kidney disease requiring Kayexalate and attended the emergency department with severe lower GI bleeding. A partial colectomy was performed in which morphological changes related to the deposit of crystals were detected. Resins can cause a broad spectrum of malignant mucosal lesions, so early diagnosis is essential to reduce mortality and improve prognosis. However, it is uncertain whether the consumption of cholestyramine and kayexalate, as well as the deposition of their crystals in the GI tract, are the causative factor of mucosal damage. Therefore, resins should help establish the correct diagnosis and prompt medical treatment to avoid harmful results.

ORAL CANCER NOVEL TREATMENTS AND APPROACHES

The aggressive tumour known as oral cancer can metastasize, produce a high fatality rate, and infect nearby tissue. Surgery, chemotherapy, and radiation therapy, for example, are common treatment options that, when used in clinical settings, have both minimal drawbacks and major side effects. Currently, oral therapeutic medication delivery using targeted drug administration is proving to be effective. In recent years, an effective alternative therapy known as “nanomedicine,” or using nanoplatforms to deliver drugs for the treatment of cancer, has evolved. Thanks to the use of nanoplatforms, drug delivery to the tumour site can be done precisely and with minimal drug degradation in the body. As a result, the drug's toxicity is diminished, its concentration at the tumour site is elevated, and its distribution to other organs is kept to minimum. We present a contemporary review of the development medication delivery targeted for the treatment of oral cancer in this article different oral delivery systems, including as cyclodextrins, liposomes, hydrogel-based forms, and nanolipids are highlighted and explored. Biomimetic systems, such as therapeutic vitamins, proteins, exosomes, and virus-like particles, with a focus on cancer treatment, are also described. The study concludes with a brief analysis of future applications for nanoplatforms in the treatment of oral cancer

ROLE OF CIRCULATING MIR-21 EXPRESSION PROFILES AND THEIR EMERGENCE AS POTENTIAL BIOMARKERS IN ORAL SQUAMOUS CELL CARCINOMA

Among the widest range of prevalent forms of cancer is oral carcinoma, which can develop anywhere in the mouth or even on the lips. Although there have been many advances in cancer treatment, the expected lifespan for OSCCs have indeed increased marginally. The load of OSCC is anticipated to increase in the near future, yet there is no sign of relief in view. Tumorigenesis is just one of the many physiological processes that can be controlled by microRNAs, a class noncoding endogenous RNAs. Several fibrosis disorders have been linked to miR- 21, and it has been utilised to distinguish oral and tongue cancer from healthy individuals. Studies empirically highlighted the significance of these transcripts as a predictor for prediction and diagnosis in OSCCs. Therefore, the present review summarizes the expression levels of miRNAs in OSCCs and evaluates their functioning in the progression or suppression of cancer. miR-21 can be considered as a prospective candidate for their translational use in OSCCs for early diagnosis prognosis surveillance and tailored treatment which should undergo further validation.

BLENDED LEARNING INNOVATIVE EFFECTIVE STUDENT CANTERED EDUCATIONAL STRATEGIES IN THE NURSING PROFESSION

Blended learning, a pedagogical approach is nowadays widely accepted as a combination of both “face-to-face” and online learning components. Concerns have grown throughout time regarding an instructional methodology and a teaching and learning strategy. Several studies and reviews all over the world highlighted that Blended Learning is the most effective method of transferring knowledge to the students and implementation of this approach in professional fields like medical, nursing, and paramedical courses will not only improve the teaching- learning environment but also motivate the students in the self-directed learning approach. The term is specifically given to the educational practice of using a combination of traditional classroom teaching and digital learning. National and internationally this method are being used in an educational institution to motivate the students in effective learning. Computers and technology have their own impact on Integrated learning and the teaching-learning process utilizes these impacts to improve the learning methods of the students.

TOXICITY OF AFLATOXIN B1 TOWARDS THE INDUCING ALTERATIONS IN THE LIVER FUNCTIONS

Since 2003, the world's developing countries are home to more than 5 billion people thought to be at danger of prolonged consumption of contaminated foods that are aflatoxic according to a number of study efforts conducted in South Africa, Egypt, and other countries in west and east Africa. Additionally, the presence occurrence of aflatoxins and their byproducts in animal tissues used to make food (such as beef and sheep meat) may contaminate human diets. As a result of their increasing prevalence, aflatoxins have recently been identified as a significant public health concern. Aflatoxins are dangerous second-generation byproducts of Aspergillus species. Due to their chemical makeup, the majority of aflatoxins are highly liposoluble substances that can be absorption from the exposed site, such as the gastro-intestinal and respiratory tracts, into the bloodstream, where they can then spread throughout the body and reach various organs, including the liver and kidneys. The primary goals of the study were to monitor and screen for levels of aflatoxin B1 in the Karbala Province using a case-control study. The connection between Aflatoxin B1 concentrations and the common biochemical indicators of liver function as well investigated. How alter liver function by Aflatoxin B1. The study also emphasised the necessity to determine the pathophysiology of AFB1's involvement in the rising number of patients with liver dysfunction. AFB1 levels were quantitated using utilising thin layer chromatography, together with High Pressure liquid chromatography being employed for the quantitative identification (HPLC). In the province of Karbala, an analysis of case-control studies was done to look at the Aflatoxin B1 affects (AFB1) exposure on kidney disease patients. AFB1 levels were quantitated using utilising thin layer chromatography with high-performance liquid chromatography to provide quality results. The evaluations of the samples that tested positive for AFB1 as well as the lipid profile and indicators of liver function tests. The findings indicated that the population under investigation had afflatoxins exposure. AFB1 was found in 100% of individuals with unknown kidney disease (KD) and in 24%, 20%, and 100% of patients with known CKD, respectively. AFB1 concentrations in serum samples ranged from 0.68 to 8.33 ng/mL for patients with questionable KD, 1.21 to For patients, 5.60 ng/mL with known KD, likewise, healthy controls ranged from 0.11 to 1.30 ng/mL. The presence of AFB1 was positively and strongly linked with liver enzymes, specifically ALT and ALP. AFB1 levels among serum samples from KD sufferers and wholesome controls showed a prolonged contact with the poison, suggesting an unknown cause. The evaluation of the biochemical marker of liver functioning supported the effect of AFB1 exposure. This work may help build effective nationwide programmes for tracking AFs exposure. The study also emphasised the necessity to determine the pathophysiology of AFB1's involvement in the rising number of patients with liver dysfunction. Future research is urged to concentrate on more comprehensive topics that cover the entire nation (Iraq)

PLACENTAL ALKALINE PHOSPHATASE AS A THRESHOLD CONCEPT FOR EARLY DETECTION OF PRIMARY LUNG CANCER

The biochemical existing tool of diagnostic methods to lung cancer cases need to be improved. In order to validate an early screening of primary tumor patients, a developed a simple procedure or technique was demanded. The aims of this study were to provide an overview of alkaline Placental Alkaline Phosphatase activity in lung cancer. Using heating inactivation method regarding the measurement of Placental Alkaline Phosphatase activity as an early diagnosis marker in lung cancer cases. Total alkaline phosphatase and Placental alkaline phosphatase activity were measured in patients of Lung cancer patients who were classified according to the site of tumor by histological picture. ALP isoenzymes were identified by heat inactivation, and compared with the most frequently applied method (ELISA). Monitoring of the Total ALP and Placental ALP activity in the studied groups using two different methods were shown a highly performance of heating method by an experimental assessment to confirm the accuracy and validity of the proposed method. The distribution of serum placental ALP isoenzyme activity in patients and control groups which was measured by two different methods were found to be (20.2-43.1) IU/L respectively (measured by heating method) and (394.3- 454.5) pg/mL measured by ELISA method) respectively. Placental ALP isoenzyme showed a high significant activity in lung cancer patients than healthy control with p value less than (0.05). That application of the heat inactivation method yields similar indication to the ones obtained by the highly and specific enzyme-linked immunosorbent assay. The results of detection Placental alkaline phosphatase in serum were in excellent agreement and could have a potentially extensive application for Placental alkaline phosphatase quantification.

Association of 25-hydroxyvitamin D with hematological profile and anthropometry in patients with glioma

SUMMARY OBJECTIVE: Gliomas are immune system suppressive tumors, and the role of vitamin D is pivotal in the immune system. This study aimed to observe if there is any significant association between the serum levels of 25-hydroxyvitamin D with hematological indices and anthropometric measurements. METHODS: A total of 75 glioma patients were included, and the information was collected on gender, age group, area, socioeconomic status, intake of vitamin D and calcium in food and supplements, skin color, sunlight exposure, body mass index, and muscle strength. A nonparametric Kendall's tau-b correlation test was performed to find a correlation between 25-hydroxyvitamin D levels and blood counts, body mass index, and muscle strength. RESULTS: The majority of patients (72%) were having low lymphocytes followed by high granulocytes and high white blood cells. The majority were having low levels of both 25-hydroxyvitamin D (84%) and calcium (73%). Patients were mainly from urban areas, and the majority belonged to middle-class families having sedentary lifestyles. The majority of patients were not taking vitamin D supplements. An insufficient amount of sunlight exposure was found in most of them. The majority of the patients were although had normal weight but weak muscle strength (74.6%). An insignificant correlation was found between 25-hydroxyvitamin D levels with the hematological indices or anthropometric measurements in brain tumor patients. CONCLUSION: Vitamin D is a powerful immune modulator, and there is a great need for sufficient amounts of sunlight exposure and vitamin D-enriched diets to prevent cancer.

Demand Side Management And Demand Response For Optimal Energy Usage: An Overview

Being more than a decade old idea, the Demand-side management (DSM) is among the most vital part of the modern smart grid. DSM enables the utilities to minimize the gap between the supply and the demand by optimizing their pattern of user loads. At the same time, it helps them in achieving economic and energy efficient systems by reducing the peak to average (PAR). The implementation of DSM programs by the utilities could help them in improving their reliability, power quality, energy, and system efficiency. On the other hand, customers could be use it to improve their load profile, reduce the peak demands, save energy, and motivate them use more and more renewable energy. Thus, both the utilities and the consumers get benefitted by the implementation of DSM program in the smart grid. This study tries to understand the application of energy efficient policies and the demand response techniques with various DSM strategies. The study mainly focuses on the various characteristics that would lead to effective implementation of DSM programs with particular attention of the residential energy demand. Also, there will be a focus on enhancement of energy efficiency leading to more effective policy responses. The researchers could find this study very helpful as it could be employed to maximize the utility profits, the total load factor, peak demand and also minimize the consumer usage bills